Inter-observer agreement among specialists in the diagnosis of oral potentially malignant disorders and oral cancer using store-and-forward technology

Objectives Oral cancer is a leading cause of morbidity and mortality. Screening and mobile Health (mHealth)-based approach facilitates early detection remotely in a resource-limited settings. Recent advances in eHealth technology have enabled remote monitoring and triage to detect oral cancer in its...

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Bibliographic Details
Published in:Clinical oral investigations 2023-12, Vol.27 (12), p.7575-7581
Main Authors: Keerthi, Gurushanth, Mukhia, Nirza, Sunny, Sumsum P, Song, Bofan, Raghavan, Shubhasini A, Gurudath, Shubha, Mendonca, Pramila, Li, Shaobai, Patrick, Sanjana, Imchen, Tsusennaro, Leivon, Shirley T., Shruti, Tulika, Kolur, Trupti, Shetty, Vivek, Vidya Bhushan, R, Ramesh, Rohan Michael, Pillai, Vijay, Kathryn, O.S, Smith, Petra Wilder, Suresh, Amritha, Liang, Rongguang, Praveen Birur, N, Kuriakose, Moni Abraham
Format: Article
Language:English
Subjects:
Dentistry
Diagnosis
Histopathology
Humans
Medical diagnosis
Medicine
Morbidity
Mouth Diseases
Mouth Neoplasms - diagnosis
Mouth Neoplasms - pathology
Observer Variation
Onsite
Oral cancer
Technology
Telemedicine
Telemedicine - methods
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Summary:Objectives Oral cancer is a leading cause of morbidity and mortality. Screening and mobile Health (mHealth)-based approach facilitates early detection remotely in a resource-limited settings. Recent advances in eHealth technology have enabled remote monitoring and triage to detect oral cancer in its early stages. Although studies have been conducted to evaluate the diagnostic efficacy of remote specialists, to our knowledge, no studies have been conducted to evaluate the consistency of remote specialists. The aim of this study was to evaluate interobserver agreement between specialists through telemedicine systems in real-world settings using store-and-forward technology. Materials and methods The two remote specialists independently diagnosed clinical images ( n =822) from image archives. The onsite specialist diagnosed the same participants using conventional visual examination, which was tabulated. The diagnostic accuracy of two remote specialists was compared with that of the onsite specialist. Images that were confirmed histopathologically were compared with the onsite diagnoses and the two remote specialists. Results There was moderate agreement ( k = 0.682) between two remote specialists and ( k = 0.629) between the onsite specialist and two remote specialists in the diagnosis of oral lesions. The sensitivity and specificity of remote specialist 1 were 92.7% and 83.3%, respectively, and those of remote specialist 2 were 95.8% and 60%, respectively, each compared with histopathology. Conclusion The diagnostic accuracy of the two remote specialists was optimal, suggesting that “store and forward” technology and telehealth can be an effective tool for triage and monitoring of patients. Clinical relevance Telemedicine is a good tool for triage and enables faster patient care in real-world settings.
ISSN:1436-3771
1432-6981
1436-3771
DOI:10.1007/s00784-023-05347-x